目的：探讨我国东西部地区不同环境气象因素对脂质异常型干眼发病的影响。

方法：多中心回顾性研究。选取2021-03-01/2022-02-28南京中医药大学附属南京中医院及新疆伊犁哈萨克自治州友谊医院眼科门诊就诊的干眼患者，统计整理一般资料(性别、年龄、就业情况、教育程度)及就诊当日室外环境气候数据(温度、湿度、空气质量指数、风力)。筛选出符合纳排的患者，应用单因素、多因素及非线性模型分析筛选出两地区脂质异常型干眼的环境相关因素。

结果：南京与伊犁两地区各自不同季节脂质异常型干眼发病情况无明显差异，两地相比，伊犁地区脂质异常型干眼发病就诊人次四季均明显多于南京地区(P<0.001)。单因素研究结果显示，影响脂质异常型干眼发病的因素有：性别、就业情况、湿度、空气质量指数、风力。多因素Logistic回归分析显示：湿度、温度、空气质量指数三种环境因素有统计学意义，在调整年龄、性别、就业情况三种混杂因素后仍然有意义。非线性分析显示温度在低于10℃时，脂质异常型干眼的发生概率随温度的降低而上升； 在10℃～15℃时，脂质异常型干眼的发生概率变化趋于平稳，当温度超过15℃后，脂质异常型干眼的发生概率随温度的升高而上升。湿度与脂质异常型干眼发病呈负相关，随湿度上升，脂质异常型干眼的发生概率下降。

结论：伊犁地区脂质异常型干眼的发病风险四季均高于南京地区。湿度、温度、空气质量等环境气候因素均会影响脂质异常型干眼的发病情况。

METHODS: This is a multicenter retrospective study. From March 1, 2021 to February 28, 2022, all patients with dry eye were selected from the ophthalmology clinic of Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine and Friendship Hospital of Xinjiang Yili Kazakh Autonomous Prefecture. General data(gender, age, employment and education)and climate data for outdoor environments(temperature, humidity, air quality index and wind)on the day of the visit were collected. Patients who met the inclusion and exclusion criteria were selected. Single factor, multiple factors and nonlinear model analysis were applied to identify environmental factors of lipid-abnormal dry eye in both regions.

RESULTS: There was no significant difference in the incidence of lipid-abnormal dry eye between Nanjing and Yili in different seasons. The incidence of lipid-abnormal dry eye in Yili was significantly higher in all seasons than in Nanjing(P<0.001). The results of univariate research showed that the factors affecting the incidence of lipid-abnormal dry eye were gender, employment, humidity, air quality, and wind. The results of multivariate Logistic regression analysis showed that humidity, temperature and air quality were statistically significant, and remained significant after adjusting for the three confounding factors of age, gender and employment situation. Nonlinear analysis showed that the probability of lipid-abnormal dry eye increased with the decrease of temperature when the temperature was below 10℃; within the range of 10℃～15℃, the probability of lipid-abnormal dry eye tended to stabilize. When the temperature exceeded 15℃, the probability of lipid-abnormal dry eye increased with the increase of temperature. Humidity was negatively correlated with the onset of lipid-abnormal dry eye. As humidity increased, the probability of lipid-abnormal dry eye decreased.

CONCLUSIONS: The risk of lipid-abnormal dry eye in Yili is higher than that in Nanjing throughout the four seasons. Humidity, temperature, air quality and other environmental and meteorological factors can all affect the incidence of lipid-abnormal dry eye.